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Archives - Advisory Opinions

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2012

01-07-2013
Advisory Opinion 12-22
(concerning an arrangement in which a hospital pays a cardiology group compensation that includes a performance bonus based on implementing certain patient service, quality, and cost savings measures associated with procedures performed at the hospital's cardiac catheterization laboratories.)
01-03-2013
Advisory Opinion 12-21
(concerning a Federally qualified health center's proposal to offer grocery store gift cards to certain patients in capitated managed care plans as an incentive to receive health screenings or other clinical services.)
12-19-2012
Advisory Opinion 12-20
(concerning a hospital's proposal to provide free access to an electronic interface to community physicians and physician practices that would allow those physicians and practices to transmit orders for certain services to, and receive the results of those services from, the hospital.)
12-07-2012
Advisory Opinion 12-19
(concerning four proposed arrangements involving a pharmacy company's provision of items and services to community homes in which its customers reside.)
12-06-2012
Advisory Opinion 12-18
(concerning a proposed arrangement whereby three municipalities will reciprocally waive the otherwise applicable cost-sharing obligations of each other's bona fide residents when providing backup emergency medical services transportation to such individuals in certain circumstances.)
11-09-2012
Advisory Opinion 12-17
(concerning a proposal for a hospice to establish a volunteer program to provide non-skilled services to terminally ill patients who do not qualify for hospice care.)
11-05-2012
Advisory Opinion 12-16
(concerning a proposal to waive cost-sharing amounts on a non-routine, unadvertised basis for insured patients, including Federal health care program beneficiaries, based on individualized determinations of financial need.)
10-30-2012
Advisory Opinion 12-15
(concerning an existing arrangement under which a hospital pays a per diem fee to physicians for providing on-call coverage for the hospital's emergency department.)
10-16-2012
Advisory Opinion 12-14
(concerning a rewards program under which consumers would earn gasoline discounts based on the amount they spend on purchases in retail supermarkets, including cost-sharing amounts paid in connection with items covered by Federal health care programs purchased in the in-store pharmacies.)
10-05-2012
Advisory Opinion 12-13
(concerning a proposal by a hearing aid supplier to begin billing Medicare for certain audiometric testing, while continuing to offer free hearing tests to prospective hearing aid customers.)
09-13-2012
Advisory Opinion 12-12
(concerning a proposed bundle billing arrangement for basic life support advanced life support joint responses.)
09-11-2012
Advisory Opinion 12-11
(concerning an ambulance supplier's proposal to routinely waive cost-sharing amounts for emergency medical services rendered on a part-time basis.)
08-30-2012
Advisory Opinion 12-10
(concerning a proposal by a radiology group to offer free insurance pre-authorization services to physicians and patients.)
07-30-2012
Advisory Opinion 12-09
(concerning reduced-rate arrangements for the provision of therapy services at state-operated veterans' homes.)
06-29-2012
Advisory Opinion 12-08
(concerning a proposal for an independent diagnostic testing facility to hire a doctor to read and interpret test results when that doctor is closely related to the owners of the independent diagnostic testing facility and is employed by a company that also employs other potential referral sources.)
06-20-2012
Advisory Opinion 12-07
(concerning an exclusive arrangement between a county and an emergency medical services company whereby the company provides emergency ambulance services to county residents.)
06-01-2012
Advisory Opinion 12-06
(concerning two proposals by an anesthesia services provider to enter into contracts with physician-owned professional corporations or limited liability companies to provide anesthesia services.)
05-01-2012
Advisory Opinion 12-05
(concerning a rewards program under which consumers would earn gasoline discounts based on the amount spent on purchases in retail stores and pharmacies, including cost-sharing amounts paid in connection with items covered by Federal health care programs.)
04-30-2012
Advisory Opinion 12-04
(concerning certain aspects of an exclusive contract for emergency transport services between a municipality and an ambulance company that reimburses the municipality for dispatch services and for certain costs incurred when municipal firefighters drive transports.)
04-26-2012
Advisory Opinion 12-03
(concerning a proposal by a municipal fire department to share certain costs related to dispatch and other services with hospital-based ambulance providers that participate in the local 911 emergency dispatch system.)
04-11-2012
Notice of Modification to Modified Advisory Opinion 08-17
(concerning Advisory Opinion No. 08-17, which was issued on 10-21-2008, as previously modified, regarding a nonprofit, tax-exempt, charitable organization's proposed arrangement to provide counseling from a law firm regarding financially needy patients' eligibility for federal and state funded benefits programs and, for patients who appear to be eligible, assistance from the law firm in applying for benefits.)
03-27-2012
Advisory Opinion 12-02
(concerning a proposal to operate a website that would display coupons and advertising from health care providers, suppliers, and other entities.)
03-15-2012
Advisory Opinion 12-01
(concerning a proposal to establish a group purchasing organization ("GPO") that would be wholly owned by an entity that also wholly owns many of the potential participants in the GPO, and to pass through to participants in the GPO a portion of the payments received by the GPO from vendors.)

2011

12-20-2011
Advisory Opinion 11-19
(concerning the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies.)
12-07-2011
Terminated Advisory Opinion 11-18
(concerning an online service that would facilitate the exchange of information between health care practitioners, providers, and suppliers.)
11-23-2011
Advisory Opinion 11-17
(concerning a proposed arrangement under which an entity would furnish allergy testing and immunotherapy laboratory services within various primary care physicians' medical offices.)
11-15-2011
Advisory Opinion 11-16
(concerning a hospital's domiciliary services program that provides transportation, lodging, and meal assistance to certain patients and their family members.)
10-18-2011
Modification of Advisory Opinion 07-18
(modifying Advisory Opinion No. 07-18, which was issued on 01-03-2008, to allow a patient assistance program to generally limit its funds to specialty pharmaceuticals and to enroll pharmacies as "Participating Pharmacies".)
10-11-2011
Advisory Opinion 11-15
(concerning a proposal under which physicians would invest in a company that would provide pathology laboratory management services to a third party.)
10-07-2011
Advisory Opinion 11-14
(concerning a proposal for ophthalmologists in a group practice to co-manage cataract surgery patients, including Medicare beneficiaries, with optometrists external to that group practice who would separately charge the beneficiaries for services related to premium refractive intraocular lenses that are not covered by the Medicare program.)
09-30-2011
Modification of Advisory Opinion 07-06
(concerning Advisory Opinion No. 07-06 which was issued on 07-23-2007 regarding the management by a health care industry consultancy of a charitable organization's arrangement to subsidize patient cost-sharing and premium obligations.)
09-06-2011
Advisory Opinion 11-13
(concerning a proposal for a county which provides emergency medical services ("EMS") transportation through its fire department, to treat revenue received from taxes as payment of otherwise applicable cost-sharing amounts owed by bona fide county residents for EMS transportation to hospitals.)
Advisory Opinion 11-12
(concerning a health system's proposal to enter into arrangements to provide neuro emergency clinical protocols and immediate consultations with stroke neurologists via telemedicine technology to certain community hospitals.)
08-04-2011
Advisory Opinion 11-11
(concerning two proposals by a supplier that furnishes medical supplies, equipment, and related services to enter into a contract with a skilled nursing facility to provide such items and services.)
08-01-2011
Advisory Opinion 11-10
(concerning an arrangement under which a company that sells a variety of health care management services will disburse pay-for-performance financial incentives on behalf of a state's Medicaid program.)
07-21-2011
Advisory Opinion 11-09
(concerning the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies.)
Advisory Opinion 11-08
(concerning an existing arrangement and a proposed arrangement involving contracts between a durable medical equipment ("DME") supplier and various independent diagnostic testing facilities ("IDTF"), pursuant to which IDTF staff members perform certain services on behalf of the DME supplier.)
06-08-2011
Advisory Opinion 11-07
(concerning the expansion of a vaccine reminder program to include entities that insure and treat patients covered by a fee-for-service Federal health care program.)
05-26-2011
Modification of OIG Advisory Opinion No. 10-07
(concerning Advisory Opinion No. 10-07 which was issued on 05-26-2010 regarding a nonprofit, tax-exempt, charitable organization's proposal to provide assistance with cost-sharing obligations to financially needy individuals, including Medicare and Medicaid beneficiaries, diagnosed with certain specified diseases.)
05-20-2011
Advisory Opinion 11-06
(concerning an online referral service whereby post-acute care providers would pay a fee to electronically receive and respond to referral requests from hospitals for post-discharge care.)
05-13-2011
Advisory Opinion 11-05
(concerning a tax-exempt charitable organization's: (1) proposal to provide financial assistance with cost-sharing obligations for certain genetic tests to financially needy individuals, including but not limited to Medicare and Medicaid beneficiaries, and (2) current practice of providing vouchers for free genetic tests to individuals who are uninsured or whose insurance does not cover genetic tests.)
  • Modification to Advisory Opinion 11-05
    (modifying Advisory Opinion 11-05, issued 05-13-2011, that concerned a tax-exempt charitable organization's: (1) proposal to provide financial assistance with cost-sharing obligations for certain genetic tests to financially needy individuals, including but not limited to Medicare and Medicaid beneficiaries, and (2) current practice of providing vouchers for free genetic tests to individuals who are uninsured or whose insurance does not cover genetic tests.)
Advisory Opinion No. 11-04
(concerning a Training Affiliation Agreement between a military medical group and a public community hospital.)
04-14-2011
Advisory Opinion 11-03
(concerning the formation of a new long-term care pharmacy and the agreement to manage all of its day-to-day operations and provide all personnel and related services necessary for its operation.)
03-24-2011
Advisory Opinion 11-02
(concerning a complimentary local transportation arrangement whereby a hospital would transport patients from physician offices located on, or contiguous to, the hospital's campus to the hospital if the patients require further treatment and cannot transport themselves.)
01-10-2011
Advisory Opinion 11-01
(concerning a network of pediatric charity hospitals plan to: (1) begin billing third-party payers, including Federal health care programs, for services rendered, and waive all cost-sharing amounts without regard to patients' financial need; (2) adopt a new financial need-based policy of providing lodging assistance, in limited circumstances, to patients, including Federal health care program beneficiaries, and their families; and (3) adopt a new financial need-based policy of providing transportation assistance, in limited circumstances, to patients, including Federal health care program beneficiaries, and their families.)

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2010

12-28-2010
Advisory Opinion 10-26
(concerning proposed payment plans for emergency and non-emergency transportation services provided for Medicaid-covered residents of skilled nursing facilities.)
11-10-2010
Advisory Opinion 10-25
(concerning the amendment of an exclusive contract for emergency ambulance transport services between a municipality and an ambulance company.)
11-04-2010
Advisory Opinion 10-23
Advisory Opinion 10-24
(both concerning a proposed arrangement between a sleep testing provider and a hospital to provide certain sleep testing equipment and services, including marketing services, for a hospital-owned sleep testing facility.)
10-14-2010
Advisory Opinion 10-22
(regarding an ambulance company's contract to exclusively provide basic life support ambulance transport services for a town.)
09-28-2010
Advisory Opinion 10-21
(concerning the use of a "preferred hospital" network as part of a Medicare Supplemental Health Insurance ["Medigap"] policy)
Advisory Opinion 10-20
(concerning a radiology group's proposal to offer free insurance pre-authorization services to referring physicians)
09-27-2010
Advisory Opinion 10-19
(concerning a proposed arrangement for a non-profit charitable organization to receive donations of cash and durable medical equipment ("DME") from pharmaceutical manufacturers, DME suppliers and others, to provide funding grants and DME to entities that serve individuals suffering from coagulation disorders, and to provide DME directly to certain financially needy individuals)
Advisory Opinion 10-18
(concerning a proposal to extend one night of free post-surgical accommodations to pediatric tonsillectomy patients insured by Federal health care programs)
09-20-2010
Advisory Opinion 10-17
(concerning two potential donations to support programs that provide services to children and families, which were included as part of a private settlement of an administrative dispute)
09-10-2010
Advisory Opinion 10-16
(concerning a cochlear implant manufacturer that seeks to compensate certain providers for the provision of otherwise unreimbursable services rendered in connection with faulty external components of a cochlear implant while the product is still under warranty)
09-08-2010
Advisory Opinion 10-15
(concerning a joint venture between two components of an academic medical center to build and own an ambulatory care center on a 50-50 basis)
Advisory Opinion 10-14
(concerning an arrangement between a sleep testing provider and a hospital to provide certain sleep testing equipment and services for a hospital-owned sleep testing facility)
08-31-2010
Advisory Opinion 10-13
(concerning a hospital's proposal to provide insurance pre-authorization services free of charge to patients and physicians)
08-30-2010
Advisory Opinion 10-12
(concerning a nonprofit, tax-exempt, charitable organization's proposal to provide financially-needy patients with grants to defray their cost-sharing obligations for drugs and/or devices to treat brain tumors and conditions incident to brain tumors)
07-30-2010
Advisory Opinion 10-11
(concerning a company's proposal to encourage health care providers to use its online program for scheduling meetings with manufacturer representatives by offering the provider an opportunity to select a public charity to which the company would make a monetary, charitable contribution in the provider's name)
06-18-2010
Advisory Opinion 10-10
(concerning an arrangement whereby two municipalities reciprocally waive otherwise applicable cost-sharing obligations of the other's bona fide residents when providing backup emergency medical services ("EMS") to such residents pursuant to a mutual response arrangement)
Advisory Opinion 10-09
(concerning a state and county health services district's proposal to transfer funds to the county in which it operates a hospital to support construction of a new communications and emergency operations center)
06-17-2010
Advisory Opinion 10-08
(concerning two affiliated corporate entities that each own and operate a freestanding radiation oncology center proposing to provide the services of a dietitian and social worker at no additional charge to each center's Medicare cancer patients as part of the patients' treatment)
06-03-2010
Advisory Opinion 10-07
(concerning a nonprofit, tax-exempt, charitable organization's proposal to provide assistance with cost-sharing obligations to financially needy individuals, including Medicare and Medicaid beneficiaries, diagnosed with certain specified diseases)
05-27-2010
Advisory Opinion 10-06
(concerning a patient assistance program that assists underinsured patients with their prescription drug co-payment obligations)
Advisory Opinion 10-05
(concerning a proposed rewards program for referrals of prospective residents to the requestor's continuing care retirement communities by current residents and employees)
05-06-2010
Advisory Opinion 10-04
(concerning a proposal by several imaging providers to offer free insurance pre-authorization services to patients and physicians)
02-23-2010
Advisory Opinion 10-01
Advisory Opinion 10-02
Advisory Opinion 10-03
(concerning the use of a "preferred hospital" network as part of a Medicare Supplemental Health Insurance ["Medigap"] policy)

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2009

10-07-2009
Advisory Opinion 09-17
(concerning a joint venture to provide EMS and scheduled ambulance transportation services)
09-24-2009
Advisory Opinion 09-16
(concerning a proposed arrangement between a professional organization and a referral service)
09-03-2009
Advisory Opinion 09-15
(concerning an exclusive contract for ambulance transport services between a municipality and an ambulance company that provides reimbursement to the city for the costs of providing emergency dispatch services and for monitoring the quality of the emergency ambulance operation)
Advisory Opinion 09-14
(concerning an exclusive contract for ambulance transport services between a township and an ambulance company that provides for reimbursement to the township for the costs of providing emergency dispatch services)
08-18-2009
Advisory Opinion 09-13
(concerning a proposal for a hospital to provide subsidies to an affiliated ambulance cooperative, to enable the cooperative to provide certain ambulance services currently provided by the hospital)
08-14-2009
Advisory Opinion 09-12
(concerning a proposal for a government entity to subsidize copayments for outpatient prescription drugs owed by certain financially needy Medicare Part D enrollees)
08-10-2009
Advisory Opinion 09-11
(concerning the provision of free blood pressure screenings to walk-in visitors at a hospital)
07-31-2009
Advisory Opinion 09-10
(concerning the proposed use of a "preferred hospital" network as part of a Medicare Supplemental Health Insurance ["Medigap"] policy)
07-29-2009
Advisory Opinion 09-09
(concerning a proposed joint venture involving ownership of an ambulatory surgery center by a hospital and physicians)
07-28-2009
Advisory Opinion 09-08
(concerning a proposed institutional patient assistance program that would make certain drug products available to people without prescription drug coverage through the provision of replacement stock to certain participating disproportionate share hospitals)
06-30-2009
Advisory Opinion 09-06
(concerning an existing arrangement in which a hospital has agreed to share with a cardiology group, a vascular surgical group, and an interventional radiology group a percentage of the hospital's cost savings arising from the physicians' implementation of a number of cost-reduction measures in certain cardiac catheterization procedures)
Advisory Opinion 09-07
(concerning a proposal to expand an existing program that provides free oral nutritional supplements to malnourished end-stage renal disease patients who are on dialysis)
05-26-2009
Notice of Modification of OIG Advisory Opinion 08-11
(concerning Advisory Opinion No. 08-11, which was issued on 09-04-2008, regarding the waiving of cost sharing obligations for protocol-required clinical services and oxygen therapy provided to Medicare beneficiaries who participate in the Long-term Oxygen Treatment Trial sponsored by the National Heart, Lung, and Blood Institute and the Centers for Medicare and Medicaid Services)
05-21-2009
Advisory Opinion 09-05
(concerning a hospital's proposal to compensate physicians for on-call services performed on behalf of the hospital's uninsured patients)
05-18-2009
Advisory Opinion 09-04
(concerning a nonprofit, tax-exempt, charitable organization's arrangement to provide financial assistance with cost-sharing obligations associated with certain advanced diagnostic testing owed by financially needy patients, including Medicare and Medicaid beneficiaries)
04-30-2009
Advisory Opinion 09-03
(concerning an arrangement whereby three municipalities reciprocally waive otherwise applicable cost-sharing obligations of individuals residing within each other's borders when providing backup emergency medical services transportation)
04-02-2009
Advisory Opinion 09-02
(concerning an employment contract entered into concurrently with a real estate purchase contract between the employer and new employee)
03-13-2009
Advisory Opinion 09-01
(concerning a complimentary local transportation program for friends and family of residents of a skilled nursing facility)

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2008

01-07-2009
Advisory Opinion 08-24
(concerning investments in a rural medical practice group by 23 physicians and podiatrists)
12-19-2008
Advisory Opinion 08-23
(concerning a proposal for a county, which provides emergency medical services (EMS) transportation through its fire department, to treat revenue received from taxes as payment of otherwise applicable cost-sharing amounts owed by bona fide county residents for EMS transportation to hospitals)
12-15-2008
Advisory Opinion 08-22
(concerning certain part-time physician employment arrangements)
12-08-2008
Advisory Opinion 08-21
(concerning a multiple-year arrangement in which a hospital has agreed to share, with cardiology groups and a radiology group, a percentage of the hospital's cost savings arising from the physicians' implementation of cost reduction measures in certain cardiac catheterization procedures)
11-26-2008
Advisory Opinion 08-20
(concerning a proposal whereby two suppliers of durable medical equipment, prosthetics, orthotics and supplies will (i) place inventory in consignment closets on-site at certain hospitals and (ii) have licensed personnel on-call or on-site at the hospitals to train and educate patients who have been prescribed respiratory equipment and have selected one of the companies as their supplier upon discharge to their homes)
11-05-2008
Advisory Opinion 08-19
(concerning an Internet advertiser's proposal to extend its "pay per call" or "pay per lead" advertising business to the chiropractic industry)
10-28-2008
Advisory Opinion 08-18
(concerning a proposal whereby a medical center providing emergency medical services transportation in a county would not bill bona fide county residents for applicable cost-sharing amounts, but would instead be paid such amounts by the county from a fund consisting of tax revenue derived from a special millage)
10-21-2008
Advisory Opinion 08-17
(concerning a nonprofit, tax-exempt, charitable organization's proposed arrangement to provide financial assistance to cover cost-sharing obligations associated with outpatient drug treatment owed by financially needy Medicare or Medicaid patients with a certain disease)
10-14-2008
Advisory Opinion 08-16
(concerning a proposed arrangement by which a hospital would share with a physician-owned entity certain performance-based compensation available to the hospital under a quality and efficiency agreement with a private insurer)
Advisory Opinion 08-15
(concerning an existing multiple-year arrangement in which a hospital shares with groups of cardiologists a percentage of the hospital's cost savings arising from the cardiologists' implementation of a number of cost reduction measures in certain procedures)
10-02-2008
Advisory Opinion 08-14
(concerning a substance abuse treatment center’s use of motivational incentives to reward a patient’s achievement of certain treatment-related goals)
Advisory Opinion 08-13
(concerning the use of a “preferred hospital” network as part of a Medicare Supplemental Health Insurance (“Medigap”) policy)
09-26-2008
Advisory Opinion 08-12
(concerning a proposed arrangement under which a newly formed legal entity would provide purely administrative insurance preauthorization processing and submission services for various radiology and imaging centers)
09-24-2008
Advisory Opinion No. 08-11
(concerning the waiving of cost sharing obligations for protocol-required clinical services and oxygen therapy provided to Medicare beneficiaries who participate in the Long-term Oxygen Treatment Trial sponsored by the National Heart, Lung, and Blood Institute and the Centers for Medicare and Medicaid Services)
09-04-2008
Notice of Modification of OIG Advisory Opinion No. 04-15
(concerning Advisory Opinion No. 04-15, which was issued on 11-05-2004, regarding proposed modifications to the nonprofit, charitable organization's existing program to provide grants to financially-needy patients suffering from specific chronic or life-threatening diseases to defray the costs of prescription drug therapies)
08-26-2008
Advisory Opinion 08-10
(concerning a proposal for a physician practice group to provide space, equipment and personnel to other physician practice groups through block leases)
08-07-2008
Advisory Opinion 08-09
(concerning an arrangement under which a medical center has agreed to share with groups of orthopedic surgeons and a group of neurosurgeons a percentage of the medical center's cost savings arising from the surgeons' implementation of a number of cost reduction measures in spine fusion surgical procedures)
07-25-2008
Advisory Opinion 08-08
(concerning an investment in an ambulatory surgery center by a group of surgeons and a health care corporation that owns hospitals)
07-07-2008
Advisory Opinion 08-07
(concerning a proposal for a health care system to provide $10 gift cards to patients whose service expectations were not met)
05-09-2008
Advisory Opinion 08-06
(concerning a laboratory's proposal to provide services consisting of the labeling of test tubes and specimen collection containers at no cost to dialysis facilities)
02-22-2008
Advisory Opinion 08-05
(concerning a pharmaceutical company's proposal to place in certain physicians' offices electronic kiosks that offer patients free disease state screening questionnaires)
02-12-2008
Advisory Opinion 08-04
(concerning a proposal to offer a free trial prescription program to hemophilia A patients who are Federal health care program beneficiaries)
02-08-2008
Advisory Opinion 08-03
(concerning a proposed arrangement by which a health care system would provide prompt pay discounts to Federal health care program beneficiaries and other insured patients in connection with both inpatient and outpatient care)
02-05-2008
Advisory Opinion 08-02
(concerning a marketing and research company's proposal to encourage physicians and other health care professionals to complete online surveys by offering them the opportunity to designate a public charity to which the company or one of its clients would make a monetary charitable contribution)
02-01-2008
Advisory Opinion 08-01
(concerning a non-profit corporation's program that arranges for pharmaceutical manufacturer patient assistance programs to provide donated drugs to free clinics and Federally qualified health centers (FQHCs) for use by financially-needy patients who do not have any form of outpatient prescription drug insurance coverage)

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2007

01-14-2008
Advisory Opinion 07-22
(concerning an arrangement in which a hospital has agreed to share with a group of anesthesiologists a percentage of the hospital's cost savings arising from the anesthesiologists' implementation of a number of cost reduction measures related to anesthesia services provided during cardiac surgical procedures)
Advisory Opinion 07-21
(concerning an arrangement in which a hospital has agreed to share with a group of cardiac surgeons a percentage of the hospital's cost savings arising from the surgeons' implementation of a number of cost reduction measures in certain surgical procedures)
01-03-2008
Advisory Opinion 07-20
(concerning an investment by a physician in an imaging center in a medically underserved area devastated by Hurricane Katrina)
Advisory Opinion 07-19
(concerning an arrangement whereby a radiology group practice prepares written reports of its interpretations of radiology tests for a critical access hospital without charge to the hospital)
Advisory Opinion 07-18
(concerning the management by a health care industry consultancy of a charitable organization's arrangements to subsidize patient cost-sharing and premium obligations)
12-26-2007
Advisory Opinion 07-17
(concerning a proposal by an excluded individual to license an invention to a new company)
12-13-2007
Advisory Opinion 07-16
(concerning a home health agency's practice of providing prospective orthopedic patients with free educational videos containing instructions for postoperative home-based convalescence)
12-10-2007
Advisory Opinion 07-15
(concerning the use of a "preferred hospital" network as part of a Medicare Supplemental Health Insurance ("Medigap") policy)
10-19-2007
Advisory Opinion 07-14
(concerning a county's exclusive contracts for emergency ambulance services, which set out how private ambulance companies should absorb the costs of transporting uninsured arrestees and reimburse the county for the costs of providing certain administrative and emergency dispatch services)
Advisory Opinion 07-13
(concerning the addition of optometrists as owners of three single-specialty ophthalmology ambulatory surgical centers)
10-17-2007
Advisory Opinion 07-12
(concerning two proposals to accept low or no-cost bids for the provision of therapy services at state-operated veterans' homes)
10-03-2007
Advisory Opinion 07-11
(concerning a nonprofit, tax-exempt, charitable organization's proposal to establish a foundation to provide financially needy cancer patients with grants to defray their out-of-pocket treatment costs)
09-27-2007
Advisory Opinion 07-10
(concerning the physicians' on-call coverage and uncompensated inpatient care arrangement employed by a medical center)
08-28-2007
Advisory Opinion 07-09
(concerning a reward program under which certain consumers receive an annual reward based on the amount spent on purchases, including purchases of items covered by Federal health care programs)
07-30-2007
Advisory Opinion 07-08
(concerning a durable medical equipment supplier's proposed arrangement to provide patients with a free in-home congestive heart failure assessment)
Advisory Opinion 07-07
(concerning a cash donation to a senior residence program from a charitable foundation which shares ties with the program and with a local health system)
Advisory Opinion 07-06
(concerning the management by a health care industry consultancy of a charitable organization's arrangement to subsidize patient cost-sharing and premium obligations)
06-19-2007
Advisory Opinion 07-05
(concerning a proposal for certain physician investors in an established ambulatory surgery center to sell a portion of their ownership interests to a local hospital)
04-06-2007
Advisory Opinion 07-04
(concerning a pharmaceutical company's patient assistance programs, which will provide free outpatient prescription drugs to financially-needy Medicare Part D enrollees entirely outside of the Part D benefit)
04-03-2007
Advisory Opinion 07-03
(concerning the use of rewards from credit card issuers for the benefit of a residential health care facility and its employees)
03-07-2007
Advisory Opinion 07-02
(concerning a hospital's proposal to subsidize the cost of ambulance transportation for patients transported to the hospital from outside the hospital's local area)
01-25-2007
Advisory Opinion 07-01
(concerning a hospital's proposal to provide free dialysis services to chronic dialysis patients unable to obtain dialysis in their community)

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2006

11-16-2006
Advisory Opinion 06-22 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings arising from the surgeons' implementation of a number of cost reduction measures in certain surgical procedures)
11-09-2006
Advisory Opinion 06-21 (PDF)
(concerning a pharmaceutical company's proposal to establish a patient assistance program to provide outpatient prescription drugs to financially-needy Medicare Part D enrollees entirely outside of the Part D benefit)
11-08-2006
Advisory Opinion 06-20 (PDF)
(concerning a durable medical equipment supplier's practice of providing patients with free home oxygen until the patients qualify for Medicare coverage of oxygen, as well as the supplier's proposed arrangement to provide patients with a free overnight oximetry test)
11-02-2006
Advisory Opinion 06-19 (PDF)
(concerning a pharmaceutical company's proposal to establish a patient assistance program to provide outpatient prescription drugs to financially-needy Medicare Part D enrollees entirely outside of the Part D benefit)
Advisory Opinion 06-18 (PDF)
(concerning a volunteer services program for the provision of specialty medical care and professional development in rural areas, through which volunteers' travel costs would be covered)
10-13-2006
Advisory Opinion 06-17 (PDF)
(concerning payment of certain compensation owed by the organizer of a dental preferred provider organization to a dental network marketing and management company in connection with the use of the dental network by a Federal employee health benefits plan)
10-10-2006
Advisory Opinion 06-16 (PDF)
(concerning a proposed arrangement for a durable medical equipment ("DME") manufacturer to provide advertising assistance and reimbursement consulting services to some of its customers)
10-06-2006
Advisory Opinion 06-15 (PDF)
(concerning an arrangement under which a managed care company will disburse pay-for-performance financial incentives on behalf of a State's Medicaid program)
09-26-2006
Advisory Opinion 06-14 (PDF)
(concerning a pharmaceutical manufacturer's proposal to establish a patient assistance program to provide the company's drugs to financially-needy Medicare Part D enrollees outside of the Part D benefit)
09-25-2006
Advisory Opinion 06-13 (PDF)
(concerning a nonprofit, tax-exempt, charitable organization's proposal to provide financially needy persons who have [diseases redacted] with grants to defray the costs of premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medicare Supplementary Health Insurance, and Medicare Advantage)
  • Modification of Advisory Opinion 06-13 (modifying Advisory Opinion 06-13 issued September 18, 2006 that concerned a nonprofit, tax-exempt, charitable organization's proposal to provide financially needy persons who have [diseases redacted] with grants to defray the costs of premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medicare Supplementary Health Insurance, and Medicare Advantage.)
Advisory Opinion 06-12 (PDF)
(concerning a municipality's exclusive contract arrangement for non-emergency inter-facility ambulance transport services)
Advisory Opinion 06-11 (PDF)
(concerning a municipality's exclusive contract arrangement for non-emergency inter-facility ambulance transport services)
09-19-2006
Advisory Opinion 06-10 (PDF)
(concerning a nonprofit, tax-exempt, charitable organization's practice of providing certain therapy management services and assistance with Medicare cost-sharing obligations to financially needy Medicare beneficiaries undergoing medical treatment for certain diseases)
08-25-2006
Advisory Opinion 06-09 (PDF)
(concerning a nonprofit, tax-exempt, charitable organization's proposals to subsidize Medicare Part D premium and cost-sharing obligations owed by financially needy patients with end-stage renal disease and chronic kidney disease)
06-30-2006
Advisory Opinion 06-08 (PDF)
(concerning a free clinic's practice of dispensing drugs on behalf of patient assistance programs ("PAPs") sponsored by pharmaceutical manufacturers that provide free drugs to financially-needy patients, including some patients enrolled in the Medicare Part D outpatient prescription drug benefit)
06-29-2006
Advisory Opinion 06-07 (PDF)
(concerning a proposal by a municipality, which provides emergency medical services through a municipally owned and operated ambulance service, to treat revenue received from local taxes as payment of otherwise applicable cost-sharing amounts due from municipal residents)
05-08-2006
Advisory Opinion 06-06 (PDF)
(concerning a proposed exclusive arrangement for emergency ambulance services)
05-03-2006
Advisory Opinion 06-05 (PDF)
(concerning a research hospital's practice of providing drugs and supplies to its affiliates for administration to the hospital's patients receiving treatment at the affiliates)
04-27-2006
Advisory Opinion 06-04 (PDF)
(concerning a nonprofit, tax-exempt, charitable corporation's proposal to provide financially needy Medicare beneficiaries with assistance with premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medigap [as hereinafter defined], and Medicare Advantage)
04-18-2006
Advisory Opinion 06-03 (PDF)
(concerning a pharmaceutical company patient assistance program that provides free outpatient prescription drugs to financially-needy Medicare Part D enrollees entirely outside of the Part D benefit)
03-28-2006
Advisory Opinion 06-02 (PDF)
(concerning two proposed programs to manage the delivery of durable medical equipment and orthotics to be offered to physicians by a durable medical equipment and orthotics manufacturer and supplier)
03-27-2006
Advisory Opinion 06-01 (PDF)
(concerning a home health agency's practice of providing prospective customers with a free preoperative home safety assessment)

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2005

11-07-2005
Advisory Opinion 05-12 (PDF)
(concerning a proposal to enter into a joint venture to establish a day treatment facility to provide psychiatric services to pediatric patients)
08-16-2005
Advisory Opinion 05-11 (PDF)
(concerning a hospital's proposed donation of a medical office building to a state-affiliated medical school that will use the building to relocate the school's existing family medicine clinic)
06-16-2005
Advisory Opinion 05-10 (PDF)
(concerning a proposal by a municipal corporation that provides emergency medical services (EMS) through its fire department to treat revenue received from certain local taxes as payment of otherwise applicable cost-sharing amounts due from residents and nonresident taxpayers who receive EMS within the municipality)
06-13-2005
Advisory Opinion 05-09 (PDF)
(concerning a proposal by a municipality, which provides emergency medical services ("EMS") through its fire department, to treat revenue received from local taxes as payment of otherwise applicable cost-sharing amounts due from residents of one of its service areas)
Advisory Opinion 05-08 (PDF)
(concerning a laboratory's proposal to provide free blood collection supplies to physicians and pay those physicians for the collection of blood samples)
02-25-2005
Advisory Opinion 05-07 (PDF)
(concerning an exclusive contract for ambulance services between a municipality and ambulance company that provides for an in-kind exchange of dispatch services and billing services between the parties)
02-25-2005
Advisory Opinion 05-06 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings arising from the surgeons' implementation of a number of cost reduction measures in certain surgical procedures)
Advisory Opinion 05-05 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiologists a percentage of the hospital's cost savings arising from the cardiologists' implementation of a number of cost reduction measures in certain procedures)
02-17-2005
Advisory Opinion 05-04 (PDF)
(concerning a proposed arrangement in which a hospital will share with each of eight cardiology groups a percentage of the hospital's cost savings arising from the cardiology group's implementation of a number of cost reduction measures in certain cardiac catheterization laboratory procedures)
Advisory Opinion 05-03 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings arising from the surgeons' implementation of a number of cost reduction measures in certain surgical procedures)
Advisory Opinion 05-02 (PDF)
(concerning a proposed arrangement in which a hospital will share with five cardiology groups a percentage of the hospital's cost savings arising from the cardiologists' implementation of a number of cost reduction measures in certain cardiac catheterization laboratory procedures)
02-03-2005
Advisory Opinion 05-01 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings arising from the surgeons' implementation of a number of cost reduction measures in certain surgical procedures)

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2004

01-06-2005
Advisory Opinion 04-19 (PDF)
(concerning a malpractice insurance subsidy arrangement between a hospital and two neurosurgeons)
12-29-2004
Advisory Opinion 04-18 (PDF)
(concerning a series of cash donations to a nonprofit hospice from a charitable foundation affiliated with a health system)
12-17-2004
Advisory Opinion 04-17 (PDF)
(concerning a proposed contractual joint venture arrangement for the provision of pathology services)

11-24-2004
Advisory Opinion 04-16 (PDF)
(concerning a proposal to provide laboratory employees and related equipment and supplies at no cost to dialysis facilities for the purpose of preparing specimens for delivery to the laboratory)
11-05-2004
Advisory Opinion 04-15 (PDF)
(concerning grants provided by a nonprofit, charitable organization to financially-needy patients suffering from specific chronic or life-threatening diseases to defray the costs of prescription drug therapies)
11-04-2004
Advisory Opinion 04-14 (PDF)
(concerning a proposal to treat revenue received from local taxes as payment of otherwise applicable cost-sharing amounts owed for emergency ambulance services furnished by a city)
10-12-2004
Advisory Opinion 04-13 (PDF)
(concerning a municipal corporation that owns and operates an ambulance service and that proposes to treat revenue received from local real estate taxes as payment of otherwise applicable cost-sharing amounts due from residents)
09-28-2004
Advisory Opinion 04-12 (PDF)
(concerning a municipality that owns and operates an ambulance service and that proposes to treat revenue received from local income taxes as payment of otherwise applicable cost-sharing amounts due from taxpayers who receive ambulance services within the municipality)
09-09-2004
Advisory Opinion 04-11 (PDF)
(concerning a proposed arrangement to subsidize malpractice insurance expenses for four community-based obstetricians)
08-11-2004
Advisory Opinion 04-10 (PDF)
(concerning a county's proposal to enter into an exclusive arrangement for emergency ambulance services, with payment by the second responder to the first responder for the first responder's services)
07-22-2004
Advisory Opinion 04-09 (PDF)
(concerning a geriatric group practice's proposal to employ certain primary care physicians to serve as consultants in connection with the group's nursing home patients)
06-30-2004
Advisory Opinion 04-08 (PDF)
(concerning a proposal by a physician group practice to develop and own a comprehensive physical therapy center and to lease the center's space, equipment, and personnel to physicians with patients requiring physical therapy services)
06-24-2004
Advisory Opinion 04-07 (PDF)
(concerning a health system's provision of professional consultative services to low-income schoolchildren in predominantly rural areas through a sponsored telemedicine network)
06-14-2004
Advisory Opinion 04-06 (PDF)
(concerning a municipal corporation that is proposing to reduce its fees for ambulance services for residents by an amount consistent with their cost-sharing obligations)
06-09-2004
Advisory Opinion 04-05 (PDF)
(concerning participation as a volunteer pathology laboratory for a charitable foundation's medical assistance program for low-income, uninsured patients)
06-02-2004
Advisory Opinion 04-04 (PDF)
(concerning a proposed program to provide free vision screening tests for infants)
06-01-2004
Advisory Opinion 04-03 (PDF)
(concerning a marketing company's arrangement to design, develop, and implement physician surveys conducted on behalf of pharmaceutical firms)
03-08-2004
Advisory Opinion 04-02 (PDF)
(concerning a proposal by a political subdivision of a municipality that owns and operates an ambulance service to treat revenue received from a special utility assessment as payment of otherwise applicable cost-sharing amounts due from residents)
02-09-2004
Advisory Opinion 04-01 (PDF)
(concerning the waiver of Part B cost-sharing obligations for equipment and supplies used by Medicare beneficiaries to monitor blood glucose levels in a clinical trial sponsored by the National Institutes of Health)

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2003

12-18-2003
Advisory Opinion 03-15 (PDF)
(concerning a proposal to reintegrate a medical group and a hospital that were originally a single entity and whether the proposed arrangement would violate the anti-kickback statute)
07-03-2003
Advisory Opinion 03-14 (PDF)
(concerning an arrangement between a hospital and an ambulance company providing emergency air ambulance services to trauma victims in a rural setting, and whether the provision of free helipad and crew resting quarters would violate the anti-kickback statute)
06-23-2003
Advisory Opinion 03-13 (PDF)
(concerning whether a joint venture ownership of a freestanding magnetic resonance imaging center in a rural area could potentially violate the anti-kickback statute)
05-29-2003
Advisory Opinion 03-12 (PDF)
(concerning a proposed joint venture between a medical center and a radiology group to own and operate an outpatient open magnetic resonance imaging facility)
05-28-2003
Advisory Opinion 03-11 (PDF)
(concerning an ambulance company's proposed arrangement to collect a fixed annual subscription fee in lieu of Medicare Part B cost-sharing amounts from its members)
05-15-2003
Advisory Opinion 03-10 (PDF)
(concerning a proposed arrangement by which a Medigap plan would indirectly contract with hospitals for discounts on the otherwise applicable Medicare inpatient deductibles for its policyholders and would also, at the time of the next policy renewal, reduce the premium for policyholders utilizing a network hospital for an inpatient stay)
04-25-2003
Advisory Opinion 03-9 (PDF)
(concerning a proposed arrangement by which a municipal corporation that owns and operates an ambulance service would treat revenue received from local real estate taxes as payment as applicable copayments/deductibles due from residents)
04-10-2003
Advisory Opinion 03-8 (PDF)
(concerning a proposed arrangement that would involve a company developing and managing distinct part inpatient rehabilitation units located within general acute care hospitals in exchange for a management fee calculated on a per patient per day basis)
03-26-2003
Advisory Opinion 03-7 (PDF)
(concerning a proposed arrangement under which a renal dialysis facility would provide acute hemodialysis services to a hospital district's inpatients, provide outpatient chronic hemodialysis services to some of the hospital district's indigent patients, and purchase certain hemodialysis equipment from the hospital district)
Advisory Opinion 03-6 (PDF)
(concerning an arrangement involving a medical center providing physician services to a county-owned women's health clinic for an annual below fair-market value fee, along with inpatient hospital services for the county clinic's primarily indigent and low-income, self-paying patients at no charge)
02-13-2003
Advisory Opinion 03-5 (PDF)
(concerning a proposed ambulatory surgical center (ASC) arrangement that would be jointly owned by a hospital and a multi-specialty group practice with a substantial number of physician members who would not personally use the ASC.)
02-12-2003
Advisory Opinion 03-4 (PDF)
(concerning a proposed program by a provider of home health care services to provide free medical-alert pagers and pager monitoring service to homebound patients during the period such patients are receiving the company's home health services)
Advisory Opinion 03-3 (PDF)
(concerning a proposed modification to a drug company's patient assistance program to pay Medicare Part B cost-sharing amounts for financially needy beneficiaries following surgery)

01-21-2003
Advisory Opinion 03-2 (PDF)
(concerning a medical center's proposed acquisition of an ownership interest in an established single-specialty [orthopedic] ambulatory surgery center, together with the execution of a series of related ancillary contracts.)
Advisory Opinion 03-1 (PDF)
(concerning the potential for the imposition of sanctions against a company which has made a good faith offer of employment to an excluded individual.)

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2002

01-03-2003
Advisory Opinion 02-16 (PDF)
(concerning the waiver of Part B cost-sharing obligations for equipment and supplies used by Medicare beneficiaries to monitor blood glucose levels in a clinical trial sponsored by the National Institutes of Health)
10-07-2002
Advisory Opinion 02-15 (PDF)
(concerning a proposal by a municipal corporation that owns and operates an ambulance service to treat revenue received from local real estate taxes received from its residents as payment of otherwise applicable copayments and deductibles due from these residents for emergency ambulance services)
Advisory Opinion 02-14 (PDF)
(concerning whether a proposed program to provide free safety equipment to hemophilia patients, as well as free electronic pagers to the parents of pediatric hemophilia patients, would violate section 1128A(a)(5) of the Social Security Act)
10-04-2002
Advisory Opinion 02-13 (PDF)
(concerning whether a proposed arrangement involving financial assistance by a non-profit foundation, which a pharmaceutical company proposes to establish and fund in order to subsidize cost-sharing amounts incurred by financially needy patients using its drug, would violate the administrative authorities related to the anti-kickback statute)
08-30-2002
Advisory Opinion 02-12 (PDF)
(concerning a proposed arrangement involving an internet-based chronic disease management business that would (1) contract with managed care organizations and employer-based health plans to enroll their members in an on-line clinical compliance program that includes awarding points redeemable for goods and services to members and their physicians for undertaking compliance activities, and (2) sell advertising on its web site to advertisers, including pharmacies and pharmaceutical companies)
08-20-2002
Advisory Opinion 02-11 (PDF)
(concerning whether a State-chartered hospital authority, which owns and operates a large teaching hospital, can make substantial charitable contributions to an endowment fund affiliated with the university in order to support and promote education and research at the university's school of medicine through developing a clinical cardiology services program, and whether this grant would violate the administrative authorities related to the anti-kickback statute)
08-07-2002
Advisory Opinion 02-10 (PDF)
(concerning whether the offering of discounts to customers, based on their purchases of dialysis equipment and supplies - some of which 05/be reimbursed under different Medicare part B methodologies - would violate the administrative authorities related to the anti-kickback statute)
06-21-2002
Advisory Opinion 02-9 (PDF)
(concerning whether a proposed single-specialty ambulatory surgical center that would be wholly-owned by a physician would violate the administrative authorities related to the anti-kickback statute)
06-19-2002
Advisory Opinion 02-8 (PDF)
(concerning whether a political subdivision of a State that owns and operates an ambulance service can treat operating revenues received from local taxes as payments of applicable copayments and deductibles due from residents)
06-11-2002
Advisory Opinion 02-7 (PDF)
(concerning the proposed waiver of coinsurance for portable x-ray services provided to nursing facility residents who are eligible for Medicare and Medicaid, but who do not meet the eligibility requirements for Qualified Medicare beneficiaries)
05-22-2002
Advisory Opinion 02-6 (PDF)
(concerning whether a proposal to offer a refund program to hospital consumers who purchase the hospital's blood-filtering device for treatment of rheumatoid arthritis would constitute grounds for the imposition of sanctions under the OIG's exclusion and civil money penalty authorities)
05-14-2002
Advisory Opinion No.02-5 (PDF)
(concerning whether the proposed reorganization of an existing radiation oncology group practice would violate the administrative authorities related to the anti-kickback statute)
04-26-2002
Advisory Opinion No. 02-4 (PDF)
(concerning a durable medical equipment company's proposal to place its portable oxygen systems onsite at certain local hospitals, clinics, and physician offices for distribution to certain departing patients)
04-04-2002
Advisory Opinion No. 02-3 (PDF)
(concerning an ambulance restocking program that will satisfy the criteria for a "general replenishing" arrangement within the terms of the recently issued ambulance restocking safe harbor)
Advisory Opinion No. 02-2 (PDF)
(concerning an ambulance restocking program that will satisfy the criteria for a "general replenishing" arrangement within the terms of the recently issued ambulance restocking safe harbor)
Advisory Opinion No. 02-1 (PDF)
(concerning a non-profit, tax-exempt, charitable corporation funded largely by drug companies that would provide financial assistance to subsidize, in whole or in part, the Part B cost-sharing amounts and Medigap premiums of financially needy Medicare beneficiaries suffering from relatively rare chronic diseases)

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2001

11-26-2001
Advisory Opinion No. 01-21 (PDF)
(concerning a medical center's proposed acquisition of an ownership interest in an operating ambulatory surgical center that is currently owned by a group of gastroenterologists.)
11-21-2001
Advisory Opinion No. 01-20 (PDF)
(concerning a payment arrangement between a Medicare-certified hospice and certain nursing facilities for services provided to residents of such facilities who are eligible both for Medicaid and Medicare hospice benefits ("Dually Eligibles"). Specifically, for Dually Eligibles, the hospice pays the nursing facilities the full Medicaid nursing facility per diem rate for non-hospice patients, which covers pharmacy services, plus a separate payment for drugs used by Dually Eligibles in connection with their terminal illness. You have asked whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act.)
11-21-2001
Advisory Opinion No. 01-19 (PDF)
(concerning a hospital's proposed donation of free office space to an entity that provides free end-of-life services to patients with terminal illnesses. Specifically, whether that donation would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act.)
11-7-2001
Advisory Opinion No. 01-18 (PDF)
(concerning an exclusive contract for emergency ambulance services between County A, State B and Medical Center C under which County A has assumed the obligation to pay otherwise uncollected coinsurance amounts on behalf of County A residents. Specifically, whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act, or under the civil monetary penalties provision for illegal remuneration tobeneficiaries at section 1128A(a)(5) of the Act.)
10-17-2001
Advisory Opinion No. 01-17 (PDF)
(concerning whether an existing ambulatory surgical center ("ASC") joint venture between a hospital-affiliated entity and an entity owned indirectly by five ophthalmologists, together with the execution of three related ancillary agreements (the "Arrangement"), constitutes grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act).
10-05-2001
Advisory Opinion No. 01-16 (PDF)
(concerning a managed care organization's employment of an excluded individual and potential sanctions under section 1320a-7a(a)(6) of the SSA)
09-27-2001
Advisory Opinion No. 01-15   (PDF)
(concerning a managed care organization's proposal to subsidize the Medicare+Choice premiums andcopayments of its members eligible for both Medicare and certain limited Medicaid benefits...)
09-04-2001
Advisory Opinion No. 01-14 (PDF)
(concerning a hospital's policy of waiving out-of-pocket copayments and deductibles for screening services and certain follow-up services that the hospital offers to promote early detection of breast and gynecological cancers.
08-24-2001
Advisory Opinion No. 01-13 (PDF)
(concerning the "coordination of benefits" provisions of a provider agreement between ... a health maintenance organization or "HMO", and the skilled nursing facilities in its provider network (the "Nursing Facilities"...)
08-24-2001
Final Notice of Modification of OIG Advisory Opinion No. 98-5 (PDF)
(concerning Advisory Opinion No. 98-5, which was issued on 04/17, 1998. In OIG Advisory Opinion No. 98-5, we concluded that the Requestor's contract with a managed care organization (in particular, its coordination of benefits provision, hereafter the "COB provision") could violate the anti-kickback statute, and we could not conclude that the COB provision posed little or no risk of Federal health care program fraud and abuse.
07-26-2001
Advisory Opinion No. 01-12 (PDF)
(concerning an exclusive contract between a city and an ambulance company for the provision of emergency medical services for city residents that includes a requirement that the contracting ambulance company waive out-of pocket Medicare copayments for city residents...)
07-26-2001
Advisory Opinion No. 01-11 (PDF)
(concerning a municipal corporation that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents...)
07-26-2001
Advisory Opinion No. 01-10 (PDF)
(concerning a political subdivision of a State that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents...)
07-26-2001
Advisory Opinion No. 01-09 (PDF)
(concerning a proposed grant from a hospital to a community health center to defray the costs of providing services to uninsured patients...)
07-10-2001
Advisory Opinion No. 01-8 (PDF)
(...concerns a comprehensive program that a manufacturer of therapeutic mattresses and other support services markets and sells to State-licensed nursing facilities to manage pressure ulcers...)
07-03-2001
Advisory Opinion No. 01-7 (PDF)
(concerning the practice of accepting reimbursement from third-party payors plus certain payments...)
05-29-2001
Advisory Opinion No. 01-6 (concerning "payments by vendors to a group purchasing organization (GPO) owned by entities affiliated with health care providers that purchase items covered by the GPO's vendor contracts."
05-23-2001
Advisory Opinion No. 01-5 (PDF)
(concerning "a proposed lease of cardiac diagnostic equipment to emergency medical services providers for a nominal charge.")
05-10-2001
Advisory Opinion No. 01-4 (PDF)
(concerning "a proposed arrangement between a hospital and a new physician whom the hospital would like to recruit to practice within its service area.")
05-10-2001
Advisory Opinion No. 01-3 (PDF)
(concerning "whether proposed contracts for discounted services between a Federally-recognized Indian tribe and local hospitals would constitute grounds for the imposition of exclusions under section 1128(b)(7) of the Act or civil money penalties under section 1128A(a)(7) of the Act.")
03-27-2001
Advisory Opinion No. 01-2 (PDF)
(concerning an annual charity golf tournament for which some of its vendors and suppliers pay money as sponsors and tournament participants...)
01-18-2001
Advisory Opinion No. 01-1 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings...)

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2000

12-28-2000
Advisory Opinion No. 00-11 (PDF)
(regarding approval of a charitable donation from a hospital to a volunteer emergency medical services provider to pay for new equipment and paramedic training...)
12-28-2000
Advisory Opinion No. 00-10 (PDF)
(regarding a program designed by a drug manufacturer to promote an expensive new drug used to prevent certain respiratory infections in pediatric patients...)
12-21-2000
Advisory Opinion No. 00-09 (PDF)
(..whether a hospital proposal to provide free restocking of medical supplies and drugs for volunteer emergency medical services would violate the anti-kickback statute..)
12-12-2000
Advisory Opinion No. 00-8 (PDF)
(concerning whether a housing referral for the elderly would be subject to sanctions arising under the anti-kickback statute...)
11-24-2000
Advisory Opinion No. 00-7 (PDF)
(regarding free transportation services that a hospital offers to certain patients who have been referred to the hospital for extended courses of treatment involving...)
10-06-2000
Advisory Opinion No. 00-6 (PDF)
(concerning proposed donation of its ownership interest in a portion of a medical office building to an agency of the State for use by the Medical School...)
07-07-2000
Advisory Opinion No. 00-5 (PDF)
(..whether waiving Medicare Part A and Part B copayment and deductible obligations for participants in a clinical study sponsored by the Health Care Financing Administration and the National Heart, Lung, and Blood Institute..)
06-27-2000
Advisory Opinion No. 00-4 (PDF)
(..concerning a lifestyle modification program for individuals with chronic disease that uses physicians to monitor and evaluate the program's participants..)
04-18-2000
Advisory Opinion No. 00-3 (PDF)
(..concerning an arrangement to provide various services free of charge to patients with terminal illnesses...)
04-18-2000
Advisory Opinion No. 00-2 (PDF)
(..about a proposed cost-savings program pursuant to which (the Hospital) would reward its non-physician employees for submitting cost-savings suggestions..)
03-16-2000
Advisory Opinion No. 00-1 (PDF)
(..concerning a consulting firm's contractual payment arrangements for the performance of auditing services to identify hospital undercharges and overcharges associated with private payors..)
01-06-2000
Advisory Opinion No. 99-14 (PDF)
(..regarding rural telemedicine network arrangement implemented and operated pursuant to Federal grants)

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1999

12-07-1999
Advisory Opinion No. 99-13 (PDF)
(.. regarding certain arrangements for discounted pathology services provided to physicians..)
12-06-1999
Advisory Opinion No. 99-12 (PDF)
(..a proposed marketing program involving the use of physician practices and health care clinics to distribute coupons redeemable by certain retailers (including grocery stores, pharmacies, and internet companies) for discounts on items or services that are not reimbursable by any Federal health care program)
11-01-1999
Advisory Opinion No. 99-11 (PDF)
(..concerning an arrangement sponsored by Coalition A (the "Coalition") to provide psychotherapy services at free or reduced prices using residents from local teaching facilities as clinicians (the "Arrangement" )
11-01-1999
Advisory Opinion No. 99-10 (PDF)
(..concerning a corporate sponsorship program between Drug Company A ("Company A") and Charity B ("Charity B") (the "Proposed Arrangement"...)
10-07-1999
Advisory Opinion No. 99-9 (PDF)
(..a proposed contractual arrangement between a self-insured employer health plan and a single-specialty managed care organization to provide managed podiatry benefits for the employer's retirees ..)
07-13-1999
Advisory Opinion No. 99-8 (PDF)
(...whether an arrangement to provide for personal appearances by podiatrists to certain retail stores constitutes grounds for sanctions under the anti-kickback statute.)
06-08-1999
Advisory Opinion No. 99-7 (PDF)
(...whether an across-the-board waiver of any out-of-pocket beneficiary copayments for medical services covered by the national Eye Care Project constitutes grounds for the imposition of a sanction under section 1128A(a)(5) of the Act.)
04-14-1999
Advisory Opinion No. 99-6 (PDF)
(..whether the longstanding policy of a hospital, specializing in pediatric oncology research, of not billing its patients for any amounts associated with their treatment, including copayment amounts..)
04-08-1999
Advisory Opinion No. 99-5 (PDF)
(..whether an annual fee imposed by city ordinance on ambulance companies wishing to provide ambulance services in the city (the "Ambulance Fee") constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), and, if so, whether the Ambulance Fee assessment constitutes grounds for the imposition of sanctions..)
04-08-1999
Advisory Opinion No. 99-4 (PDF)
(..whether a proposed agreement (the "Proposed Agreement"), pursuant to which Hospital District No.1 ("District One" or the "Requestor") would locate a medical clinic within the geographic boundaries of Hospital District No. 2 ("District Two"), would constitute grounds for sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), the exclusion authority for kickbacks..)
03-23-1999
Advisory Opinion No. 99-3 (PDF)
(..whether a proposed pricing arrangement for a package of therapeutic mattresses for SNF patients to be marketed by a company, and certain commissioned agents, would result in prohibited remuneration under the anti-kickback statute...)
03-04-1999
Advisory Opinion No. 99-2 (PDF)
(..whether certain arrangements for discounted ambulance services provided to residents of Medicare skilled nursing facilities would result in prohibited remuneration and sanctions under the anti-kickback statute.)
01-27-1999
Advisory Opinion No. 99-1 (PDF)
(..whether the Arrangement constitutes prohibited remuneration within the meaning of the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act").

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1998

12-21-1998
Advisory Opinion No. 98-19 (PDF)
(...whether an arrangement whereby an independent physician association would acquire an equity interest in a managed care organization would constitute grounds for the imposition of sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), the exclusion authority for kickbacks...)
12-03-1998
Advisory Opinion No. 98-18 (PDF)
(...whether an ophthalmologist's proposed sublease to an optometrist of certain imaging equipment (the "Sublease") would meet the criteria of the equipment rental safe harbor, 42 C.F.R. 1001.952(c)...)
11-13-1998
Advisory Opinion No. 98-17 (PDF)
(...whether donations by Company X ("Company X") to Organization A ("Organization A") (an independent, 501(c)(3) charitable organization) for the purpose of funding a program to pay for Supplementary Medical Insurance ("Medicare Part B") or Medicare Supplementary Health Insurance ("Medigap") premiums for financially needy Medicare beneficiaries with end-stage renal disease...)
11-10-1998
Advisory Opinion No. 98-16 (PDF)
(...whether a proposed arrangement under which [Name redacted] would assign an employee pharmacist to work in designated hospital transplant centers for the purpose of providing pharmacy-related products and services (the "Proposed Arrangement") would constitute prohibited remuneration under the anti-kickback statute...)
11-10-1998
Advisory Opinion No. 98-15 (PDF)
(...whether an arrangement for contracted pharmacy services between University A and Pharmacy Company B to facilitate an outpatient pharmacy program for the University's hemophilia center pursuant to section 340B of the Public Health Service Act (the "Proposed Arrangement") would constitute grounds for sanctions under the anti-kickback statute...)
10-28-1998
Advisory Opinion No. 98-14 (PDF)
(...whether an existing pharmaceutical restocking program (the "Drug Program") and a proposed medical supplies restocking program (the "Supply Program) (collectively, the "Arrangements") constitute prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"),...)
10-30-1998
Advisory Opinion No. 98-13 (PDF)
(...whether an ambulance restocking program, coordinated through a local emergency medical services council (the "Program"), constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), and, if so, whether the Program constitutes grounds for the imposition of sanctions under the anti-kickback statute,...)
09-23-1998
Advisory Opinion No. 98-12 (PDF)
(...whether a proposed joint venture among several orthopedic surgeons and anesthesiologists specializing in pain management to establish an ambulatory surgical center, as described in your request letter and supplemental submissions (the "Proposed Arrangement"), would generate prohibited remuneration...)
09-21-1998
Advisory Opinion No. 98-11 (PDF)
(...whether a proposed purchasing arrangement involving a trade association, its nursing home members, and an electrical utility consultant (the "Proposed Arrangement") constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"),...)
09-08-1998
Advisory Opinion No. 98-10 (PDF)
(... whether the payment of a sales commission to an independent manufacturers' representative (the "Arrangement") constitutes grounds for sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act")...)
07-13-1998
Advisory Opinion No. 98-9 (PDF)
(...whether a compensation arrangement for registered nurses and certain other employees pursuant to a collective bargaining agreement with the nurses' union...)
07-06-1998
Advisory Opinion No. 98-8 (PDF)
(...whether Company A ("Company A"), a wholly-owned subsidiary of Company B ("Company B") (collectively referred to as "Company AB") would be subject to exclusion from Federal health care programs pursuant to 42 U.S.C. 1320a-7(b)...)
06-11-1998
Advisory Opinion No. 98-7(PDF)
(...whether an ambulance restocking and continuing education arrangement (the "Arrangement") constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act")")
04-24-1998
Advisory Opinion No. 98-6 (PDF)
(...whether waiving coinsurance obligations for participants in a clinical study sponsored by the Health Care Financing Administration and the National Heart, Lung, and Blood Institute (the "Proposed Arrangement")
04-24-1998
Advisory Opinion No. 98-5 (PDF)
(...which seeks our opinion regarding the "coordination of benefits" ("COB") provisions of a provider agreement between Nursing Home A (the "Nursing Home") and a health care plan...) Please note that a modification was made to Advisory Opinion No. 98-5 (PDF) on August 24, 2001.
04-14-1998
Advisory Opinion No. 98-4 (PDF)
(...whether a proposed management services contract between a medical practice management company and a physician practice, which provides that the management company will be reimbursed for its costs and paid a percentage of net practice revenues...)
04-14-1998
Advisory Opinion No. 98-3 (PDF)
(..whether a hospital system's provision of an ambulance to a municipal fire department as described in your request..)
04-08-1998
Advisory Opinion No. 98-2 (PDF)
(..certain pharmaceutical discount pricing arrangements that are limited to arrangements between a manufacturer and wholesalers (the "Proposed Arrangement") will subject you to sanction under the anti-kickback statute..)
03-19-1998
Advisory Opinion No. 98-1 (PDF)
(..whether a contractual arrangement for distribution and billing services between Company A and Company B (the AArrangement@) constitutes grounds for sanction under the anti-kickback statute,..)

Top

1997

10-20-1997
Advisory Opinion No. 97-6 (PDF)
(...asks whether a proposed arrangement for restocking ambulance supplies and medications (the AProposed Arrangement@) would constitute illegal remuneration as defined in the anti-kickback statute, 42 U.S.C. ' 1320a-7b(b).
10-15-1997
Advisory Opinion No. 97-5 (PDF)
(...asks whether an outpatient radiology imaging center joint venture owned by a medical group specializing in radiology and a hospital care provider (i) generates prohibited remuneration within the meaning of the anti-kickback statute, Section 1128B of the Social Security Act (AAct@); (ii) constitutes grounds for the imposition of an exclusion under Section 1128(b)(7) of the Act (as it applies to kickbacks); (iii) constitutes grounds for criminal sanctions under Section 1128B(b) of the Act; and/or (iv) satisfies the criteria set out in Section 1128B(b)(3) of the Act or associated regulations, 42 C.F.R. ' 1001.952.
10-02-1997
Advisory Opinion No. 97-4 (PDF)
(...asks whether declining to pursue collection of copayments from certain patients who have employer-sponsored Medicare complementary coverage constitutes grounds for imposition of sanctions under Section 231(h) of the Health Insurance Portability and Accountability Act ("HIPAA") [42 U.S.C. 1320a-7a(a)(5)] or under Sections 1128B(b) (the anti-kickback statute) or 1128A(7) (relating to payment of kickbacks) of the Social Security Act [42 U.S.C. 1320a-7b(b) and 1320a-7(b)(7)].
08-22-1997
Advisory Opinion No. 97-3 (PDF)
(...asks whether Mrs. P's transfer of assets to her nephew, Mr. S, and subsequent application for Medicaid benefits, subjects her to sanction under 42 U.S.C. 1320a-7b(a)(6), which prohibits certain dispositions of assets for the purpose of qualifying for Medicaid.)
07-28-1997
Advisory Opinion No. 97-2 (PDF)
(...asks whether a state-funded program that pays for insurance premiums for financially needy Medicare beneficiaries with end-stage renal disease would constitute grounds for the imposition of a civil monetary penalty under Section 231(h) of the Health Insurance Portability and Accountability Act of 1996)
06-11-1997
Advisory Opinion No. 97-1 (PDF)
(...it is permissible for a charitable organization partly funded by kidney dialysis providers to pay Medicare Part B, Medigap and other health insurance premiums for end-stage renal disease patients who are financially needy)

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